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Examination of the Philadelphia Geriatric Morale Scale as a Subjective Quality-of-Life Measure in Elderly Hong Kong Chinese

Correspondence: Address correspondence to Professor Jean Woo, Department of Medicine & Therapeutics, Prince of Wales Hospital, Shatin, N.T., Hong Kong. E-mail: jeanwoowong{at}cuhk.edu.hk

Purpose: We examine the psychometric properties of the Philadelphia Geriatric Morale Scale (PGMS) in an elderly Chinese population in Hong Kong. Design and Methods: The study consisted of two cohorts: (a) 759 participants aged 70 years and older living in the community who were recruited as part of a territory-wide health survey and interviewed in 1993–1994; and (b) 388 participants living in long-term-care institutions in 1995–1996. Participants who were cognitively impaired (Abbreviated Mental Test score less than 7) or who could not answer questions for other reasons were excluded. The 15-item PGMS was administered. The Rasch dichotomous model was used to assess the validity of the PGMS, and the 15-item Geriatric Depression Scale, previously validated in Chinese, was also administered to examine the concurrent validity. Results: A confirmatory factor analysis identified three underlying factors similar to findings among Caucasians; however, not all the goodness-of-fit indices were acceptable. An exploratory factor analysis using principal axis factoring and promax rotation revealed two underlying factors that explained 35% of the total variance: reconciled aging and unstrained affect. Some items were redundant when applied to the institutional sample. Concurrent validity was demonstrated by the good correlation between the reconciled aging and unstrained affect domains and the Geriatric Depression Scale (r = –0.72 and r = –0.56 respectively). Female gender, older age, and residence in institutions were associated with lower morale. Implications: The PGMS is a valid quality-of-life measure in elderly Hong Kong Chinese persons, but its psychometric properties are slightly different from those for Caucasians.

Key Words: Chinese • Philadelphia Geriatric Morale Scale • Validity • Quality of life

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